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Verified Answers |Latest Update |Already
Graded A+
Non-heme iron sources of food should be pair with ____ to help enhance
absorption ✔ Correct Answer--Vitamin C rich foods
what are clinical signs of Zinc deficiency? ✔ Correct Answer--dermatitis, hair
loss, frequent infection, glossitis, nail dystrophy
Low Zinc is paired with what on labs? ✔ Correct Answer--high copper, low Alk
phos Jaundice after fasting is most indicative of a genetic weakness in which
biotransformation pathway? ✔ Correct Answer--glucuronidation
Gilberts is a SNP in what? ✔ Correct Answer--UGT 1a — impairs gluruonidation
Cigarette smoking induces what CYP enzyme? ✔ Correct Answer--CYP1a
Which mineral is a cofactor for ALL CYP p450 enzymes ✔ Correct Answer--iron
What are the types of phase 1 reactions ✔ Correct Answer--Oxidation,
reduction, hydrolysis, lipolysis
What are the types of phase 2 reactions ✔ Correct Answer--Glutathione
conjunction, AA conjugation, methylation, sulfating, acetylation, glucuronidation
Which CYP enzyme metabolizes 40-45% of drugs & hormones ✔ Correct
Answer--3A
Which phase 1 enzyme metabolizes 4-oh ✔ Correct Answer--1B
Which enzyme metabolizes caffeine ✔ Correct Answer--CYP 1A
What does Gilbert's syndrome patients have an impaired ability to do?
✔ Correct Answer--Conjugate bilirubin with glucuronidation
Which mineral is a required co-factor for all CYP enzymes> ✔ Correct Answer--
Iron __ deficiency is seen with: dermatitis, hair loss, frequent infection, glossitis
✔ Correct Answer--Zinc
What types of patients cases have sulfation issues? ✔ Correct Answer--
Chemical sensitivity, Alzheimer's, Parkinson's, RA, delayed food sensitivity, diet responsive autism, Tylenol intolerance.
High levels of CYPa12 activity are associated with? In smokers ✔ Correct
Answer--Colon cancers
What SNP does Gilbert's have? ✔ Correct Answer--UGT1a
Non-heme iron needs? To enhance absorption ✔ Correct Answer--Vitamin c
What meds should Gilberts syndrome avoid? ✔ Correct Answer--acetaminophen
What are some signs of poor glucuronidation? ✔ Correct Answer--Dysbiosis,
high Beta-glucuronidase
How can you look for sulfonation issues? ✔ Correct Answer--Sulfur AA:
methionine, cystathionine, cysteine
What does glucuronidation work on? ✔ Correct Answer--Bilirubin,
steroid/thyroid hormones, prostaglandins, bile acids and lipophilic xenobiotics
How do we support sulfation? ✔ Correct Answer--High sulfur foods (seafood).
Sulfur AA (methionine, NAC, Taurine), MSM
Loss of vibratory sense can be seen with what phase 2 issue? ✔ Correct
Answer--Methylation
What are some labs to check for low glutathione ✔ Correct Answer--RBC
glutathione, blood glutathione peroxidase, serum/plasma cysteine and urine mercapturic acid (would be low) ___ deficiency is seen with: pale tongue, cheek, conjunctiva, angular stomatitis,
glossitis, fingernails ridging/brittle/spoon shaped, pale nail beds ✔ Correct
Answer--Iron
What are supportive nutrients for glucuronidation? ✔ Correct Answer--Ca D-
glucarate, quercetin, probiotics, EFAs, Mg
What is low alk phos seen with? ✔ Correct Answer--Zinc deficiency
What inhibits the absorption of iron? ✔ Correct Answer--Phytic acid
What are some beta-glucuronidase inhibitors? ✔ Correct Answer--Calcium D-
glucarate, silymarin, black currant, reishi, DGL, probiotics, prebiotic foods (inulin)
What amino acids are the main ones for AA conjugation ✔ Correct Answer--
Glycine, taurine, arginine, glutamine
What nutrients are needed for methylation support ✔ Correct Answer--
Methionine, B12 B6, betaine, folate, Mg
What does someone with SULT gene SNP have issues with ✔ Correct Answer--
Phase 2 sulfation
What does acetylation eliminate? ✔ Correct Answer--Histamine, serotonin, sulfa
drugs
For what types of conditions should we use Detox food plan? ✔ Correct
Answer--High LFTs, dysbiosis, fatigue, leaky gut, asthma/allergies
Phase 2 biotransformation conjugates reactive intermediates from phase 1 and
makes them less ____philic and more___philic ✔ Correct Answer--Lipophilic.
hydrophilic.
What does PURE stand for ✔ Correct Answer--Patter recognition,
undernourished, reduce exposures, ensure safe detox
How does pomegranate work for detox? ✔ Correct Answer--Contains Ellagic
acid which binds to DNA and protects against carcinogens What are nutritional coenzymes for desaturates metabolism of omega3 PUFAs
✔ Correct Answer--Zinc, Mg, niacin, pyridoxine, ascorbate
What competes with arginine for eNOS? ✔ Correct Answer--ADMA
Choline, betaine and carnitine turn into ___ by gut bacteria ✔ Correct Answer--
TMAO. (Get this from meat/animal products)
What are reasons for elevated BNP ✔ Correct Answer--CHF, paroxysmal Afib,
sleep apnea
What are reasons for elevated HS CRP? ✔ Correct Answer--Visceral adiposity,
poor dietary choices. Chronic infections, dysbiosis (gut mouth), lack of exercise, toxins, poor sleep
What are some things to help with insulin sensitizing ✔ Correct Answer--
Vanadium, chromium, ALA, cinnamon, Mg
What lower ADMA ✔ Correct Answer--Resveratrol, EGCG, sulforaphane,
exercise, tight glycemic control, S-adenosylhomocysteine
People with high TMAO may benefit from what type of food plan ✔ Correct
Answer--Vegan
What is LP PLA2 a marker of? ✔ Correct Answer--Vascular inflammation
What nutrients are reduced with metformin? ✔ Correct Answer--Folic acid and
B
What class of meds help dislodge lead from kidneys ✔ Correct Answer--ARBs
What increases ADMA ✔ Correct Answer--PPI, high oxidized LDL, diets poor in
arinine and folate, homocysteine and methionine
What does beta-blockers decrease? ✔ Correct Answer--Melatonin
Familial hypercholesterolemia if untreated will increase risk by? ✔ Correct
Answer--20x
where is APOe made? ✔ Correct Answer---liver, macrophages, astrocytes (CNS)
what is ApoE required for clearance of? ✔ Correct Answer---chylomicron and
IDLs
What is capsaicin used for? ✔ Correct Answer--Low back pain and nerve pain
How does capsaicin work? ✔ Correct Answer---Inhibits substance P (reducing
inflammation)
How does EGCG work to reduce inflammation ✔ Correct Answer--inhibits IL-8 in
airway epithelium, Blocks NFKB, modulates lox, down regulates IL6/IL8/TNFa
where is Apo E principal carrier of cholesterol ✔ Correct Answer--brain
For what conditions would you use EGCG? ✔ Correct Answer--most
inflammatory related conditions and CA prevention
What do ACEi and ARBs reduce? ✔ Correct Answer--Zn and sodium
How much does a normal BP dip at night? ✔ Correct Answer--10-20%
What do statins decrease? ✔ Correct Answer--CoQ10, Se, omega3, fat soluble
vitamins, carnitine and FT
What does cholestyramine decrease the absorption of? ✔ Correct Answer--Fat
soluble vitamins and minerals
What are some foods to include in HTN ✔ Correct Answer--Soy, whey, legumes,
Cold water fish, foods high in L-arginine, mixed nuts, cocoa
What do diuretics reduce? ✔ Correct Answer--K+ Mg ,folate, B6, B12, thiamine,
iodine and Se For what type of patient do you recommend cardiometabolic food plan
✔ Correct Answer--Risk factors for CVD, Met syn, Type 2 DM, HTN
What are some foods high in L-arginine ✔ Correct Answer--Lentils, walnuts,
hazelnuts
What does Digoxin reduce? ✔ Correct Answer--Mg, Calcium and phosphorus
What are some things that non-dipping BP is related to? ✔ Correct Answer--
Congestive heart disease, CVD, CVA, LVH, CKD, increase CIMT
What herbs help 'tighten up the veins' ✔ Correct Answer--Horse chestnut seed
extract
What are the criteria for familial hypercholesterolemia ✔ Correct Answer--LDL
190 + 1st degree relative with same or known premature CHD 55 men < women
What type of food/diet changes are recommended for ApoE SNP ✔ Correct
Answer--Lower glycemic index, low simple carbs, lower fat, no alcohol, more
aggressive Omega 3
What are some symptoms of UNDER methylation ✔ Correct Answer---fatigue,
depression, OCD, headaches, high histamine, high libido
How do cannabinoids work? ✔ Correct Answer--potent anti-inflammatory
(induce induction of apoptosis, inhibition of cell proliferation, suppression of cytokine production, up regulate Treg
What are indirect insulin sensitizers? ✔ Correct Answer--Berberine, NF-kB
inhibitors
What does ABCD stand for? ✔ Correct Answer--Anthropometrics and vital signs,
Biomarkers and functional labs, Clinical indicators from nutrition PE, Diet and lifestyle review
How does CBD reduce chronic pain? ✔ Correct Answer--impacting
endocannabanoid receptor activity, reducing inflammation and interacting with neurotransmitters
Where are CB2 receptors found? ✔ Correct Answer--immune system
(peripherally)
What are the major minerals? ✔ Correct Answer--Calcium, chloride, Mg,
phosphorus, K, sodium
What is a good marker to assess for vulnerable plaque? ✔ Correct Answer--Lp
PLA
Insulin resistance is ____ related to adiponectin ✔ Correct Answer--Inversely
In what order do we see labs become abnormal in light of prediabetes?
✔ Correct Answer--Elevated 2 hour postprandial insulin, elevated fasting insulin,
elevated 2 hours postprandial glucose, elevated fasting glucose
What is non dipping BP correlated with? ✔ Correct Answer--CHF, CVD, CVA, LVH,
CKD
"What stimulates HMG CoA reductase synthase? ✔ Correct Answer--Insulin and
leptin
For women where is aromatase a problem? ✔ Correct Answer--fibroids, breast
cancer, endometriomas
What raises leptin ✔ Correct Answer--Insulin, stress
What nutrient deficiency causes glossitis, lip fissures, decreased sense of smell
and scalded sensation on tongue ✔ Correct Answer--Vit B
What are trace minerals? ✔ Correct Answer--Cu, fluoride, Fe, Manganese, Se,
Zn
When do we see pain and bloating 3 hours after meal? ✔ Correct Answer--Low
pancreatic enzymes
What are ways to help cadmium detox? ✔ Correct Answer--Se, Zn, Glutathione,
NAC, antioxidant, intestinal metal binders with silica/thiols)
What therapeutic interventions lowers SHBG ✔ Correct Answer--Stinging nettle,
EPA/DHA, whey protein, glucocorticoids
"Where is aromatase active in body? ✔ Correct Answer--Skin, fat, bone, brain
And what does aromatase convert? ✔ Correct Answer--Testosterone —>
estrogen
And what up regulates aromatase activity?" ✔ Correct Answer--High insulin,
leptin, stress, inflammation"
What botanicals are good for BPH ✔ Correct Answer--saw palmetto, nettle root,
pygeum africanum, rye grass pollen, maca, Zn
what are some things that upregulate aromatase ✔ Correct Answer--
inflammation, estradiol, prostaglandin
What are 5alpha reductase inhibitors? ✔ Correct Answer--Omegas, stinging
nettle, quercetin, green tea, flax, soy isoflavones, beta-sitosterols, zn, crysin, progesterone, saw palmetto
What is the type of testosterone made in the 5alpha pathway ✔ Correct
Answer--DHT
what effects does high estrogen have on liver (can be obesity, OCPs, oral HRT,
fertility TX) ✔ Correct Answer--INC: SHBG, HDL + TG, clotting factors,
ceruloplasmin, thyroid and corticosteroid binding globulin Increasing or decreasing SHBG will decrease estrogen effect? And what are some
ways to do it? ✔ Correct Answer--Increase. By vegetarian, low fat diet, Tx
thyroid, Tx obesity Increasing or decreasing SHBG will increase estrogen effect? And what are some
ways to do it? ✔ Correct Answer--Decrease. By testosterone therapy, exercise,
growth hormone
What is ideal SHBG level in women? ✔ Correct Answer--70-
If SHBG is <40 what do you suspect? ✔ Correct Answer--Insulin resistance
If SHBG is >120 what do you think? ✔ Correct Answer--Meds/toxic burden
What form of estrogen is like a brake or "anti-estrogen" ✔ Correct Answer--
estriol What is high estrogen relative to progesterone? And was are some drivers to
consider? ✔ Correct Answer--Estrogen Dominance. Obesity, aromatase, WHR,
inflammation, caffeine, alcohol, gut dysbiosis,
What lab changes are seen with luteal phase dysfunction? ✔ Correct Answer--
decreased progesterone <
what are some drivers of luteal phase dysfunction? ✔ Correct Answer--Stress,
low fat diet, energy deficiency via low calories, excess exercise, PCOS
how does estrogen protect the cardiovascular system? ✔ Correct Answer--
They're potent VASOACTIVE hormones. Reduce inflammation and reduce oxidative stress
When should you start HRT? ✔ Correct Answer--5 years or fewer into
menopause
How do you Tx osteoporosis? ✔ Correct Answer--Heal gut, GF diet, calcium
citrate or hydroxyapatite + boron, molybdenum, Mg, K/D, strontium, HRT
When to avoid calcium for osteoporosis ✔ Correct Answer--Patients with CVD
(get through diet, but NOT DAIRY) What is the critical period hypothesis for estrogen related to cognition?
✔ Correct Answer--giving for 2-3 years around menopause can decrease cognitive
impairment 5-15 years late by 64%
what is the best combo of HRT? ✔ Correct Answer--transdermal E2 and
micronized progesterone
what are some foods with aromatase inhibiting actions? ✔ Correct Answer--flax
seeds, soy, resveratrol, white button mushrooms ___ estrogen derivatives have protective effect in the breast and CVD system?
✔ Correct Answer--methoxy estrogen derivatives
____ estrogen derivatives contribute to tumorogenesis ✔ Correct Answer--
hydroxyl metabolites
how does estrogen promote inflammation ✔ Correct Answer--stimulate COX
which inc production of inflammatory eicosanoids what effect does conjugated equine estrogens have in regards to inflammation?
✔ Correct Answer--increase CRP and IL6 levels
what lab findings do you expect to see with luteal phase dysfunction?
✔ Correct Answer--low estradiol, LH, FSH and progesterone
Excess estrogen is most associated with increased risk of ___ (Vag dryness,
cluster HA, autoimmunity or anxiety?) ✔ Correct Answer--autoimmunity
What are some hormones and other things that increase SHBG ✔ Correct
Answer--thyroxine, estradiol, caffeine, many meds
What are some things that decrease SHBG ✔ Correct Answer--testosterone,
insulin, growth hormone, prolactin, cortisol, obesity, some progestins
What does EPA inhibit to reduce inflammation? ✔ Correct Answer--delta-5-
desaturase enzyme (which blocks the metabolism of AA)
What are sources of omega 6? ✔ Correct Answer--peanut, Corn, sunflower and
soybean oils
what are coenzymes for desaturase metabolism of omega3 PUFAs ✔ Correct
Answer--Zn, Mg, ascorbate, niacin, pyridoxine
What is AA found in? and what is it the precursor to? ✔ Correct Answer--meat,
diary, poultry, shellfish. inflammatory PGE2, L1B4, 5-HETE
A lower Omega-6:3 lowers what enzyme? ✔ Correct Answer--Delta 6
desaturase (less AA shunting)
what lab markers rise rapidly with acute-phase inflammation? ✔ Correct
Answer--CRP (as much as 100x within 24-48H), serum Amyloid A, plasma
glutathione
What are acute phase reactants? ✔ Correct Answer--Circulating inflammatory
mediators. They can increase / intensify a local response. They include: CRP, circulating prostaglandins, kinins, cytokines, the complement cascade and the clotting cascade.
What are acute phase response interleukins? ✔ Correct Answer--IL-1, IL-6, IL-
When is TNF-alpha seen inc? what does it induce? ✔ Correct Answer--obesity.
insulin resistance
What is the definition of food allergy? ✔ Correct Answer--Immunologic IgE-
mediated type 1 hypersensitivity
What is the definition of food sensitivity ✔ Correct Answer--immunologic RXN to
food (IgG mediated delayed hypersensitivity)
What is definition of food intolerance? ✔ Correct Answer--non-immunologic
reaction to food (Ie lactose or histamine intolerance)
What is the 1/2 life of IgG ✔ Correct Answer--23 days
What is the 1/2 life of IgA ✔ Correct Answer--5-6 days
what is the 1/2 life of IgE ✔ Correct Answer--2.3 days
What immunoglobulin isotype crosses placenta , activates complement cascade
and protects tissue? ✔ Correct Answer--IgG
which immunoglobulin isotype has extreme sensitivity, attaches to mast cell,
causes release of histamine, anti parasitic and is gatekeeper for IgA? ✔ Correct
Answer--IgE
Which immunoglobulin subtype protects the mucosa, clears absorbed food
antigens through the biliary system? ✔ Correct Answer--IgA
What are important ATMs for food allergies? ✔ Correct Answer--barrier
permeability, hypochlorhydria, nutrient deficiencies, stress, obesity, toxin exposures, (abx, vaccine, NSAIDs, PPIs)
Intestinal permeability is required for Ig__ sensitization ✔ Correct Answer--IgE
why do you need to combine GLA with EPA? ✔ Correct Answer--to inhibit
conversion to AA
what activates NFKB ✔ Correct Answer--oxidative stress, infection,
inflammatory cytokines, chronic diseases, overVAT
what botanicals modulate NFKb, COX and LOX modulatory activity? ✔ Correct
Answer--curcuminoids, Chinese skullcap
what does melatonin modulate in regards to inflammation? ✔ Correct Answer--
COX
What are botanicals that modulate COX? ✔ Correct Answer--bromeliad,
capsaicin, rosemary, Chinese skullcap, curcumin, feverfew, ginger, green tea, melatonin, trans-resveratrol, thyme, willow bark
what are botanicals that modulate LOX ✔ Correct Answer--Chinese skullcap,
curcuminoids, ginger, boswellia, licorice, milk thistle, quercetin
What botanicals modulate NFkB ✔ Correct Answer--willow bark, quercetin, milk
thistle, turmeric, teas, brassica veggies, garlic, devils claw, boswellia, cats class, Chinese skullcap, feverfew, pomegranate, echinacea, transresveratrol
when to use boswellia? ✔ Correct Answer--asthma, OA. IBD, RA
What botanical inc fibrinolytic activity and therefore is a good choice post-
procedure for scar tissue/bruising? ✔ Correct Answer--bromelain
how does quercetin work to reduce inflammation/allergies ✔ Correct Answer--
inhibits phospholipase A2, blocks LOX/COX, inhibits TGF alpha-induced COX activity, inhibits histamine release
what are good botanicals/vitamins that are good for antihistamines? ✔ Correct
Answer--quercetin, PEA, butterbur, vit C, stinging nettles, bromelain, luteolin
what nutraceutical maintains integrity and function of all mucosal surfaces?
✔ Correct Answer--vit a
which nutraceutical stimulates immature and naive immune cells? ✔ Correct
Answer--vit D
which nutraceutical is fuel for cells of immune system? ✔ Correct Answer--oral
glutamine
which nutraceutical enhances NK cell activity in the elderly? ✔ Correct Answer--
probiotics what botanical immunomodulator is antiviral, induces interferon and is good for
low cortisol? ✔ Correct Answer--licorice
what botanical immunomodulator is an adaptogenic herb, prevention/tx of colds,
reduces #/severity of HSV ✔ Correct Answer--siberian ginseng
what botanical immunomodulator is an adaptogen, lowers cortisol, inc thyroid
hormone synthesis, anti-cancer properties, immunomodulation ✔ Correct
Answer--ashwaganda
what are indications for Larch arabinoglactan? ✔ Correct Answer--prebiotic,
enhances phagocytosis, NK cell activity, anti-inflammatory
what are immunologic effects of astragalus? ✔ Correct Answer--bone marrow
stimulation and maturation, Ig production and activation of NK and T cells
what are indications of echinacea ✔ Correct Answer--increased neutrophil
chemotaxis, phagocytosis, oxidative burst, inc NK # and activity, inc TNFalpha
what are glutathione enhancers? ✔ Correct Answer--NAC, glutathione, ALA,
whey protein, sulforaphane, silymarin, andrographis, curcumin
What inhibits delta-6-desaturase (D6D) enzyme activity? ✔ Correct Answer--
alcohol, aging, diabetes, radiation
what does D6D (delta-6-desaturase) do? ✔ Correct Answer--converts linoleic
acid—> GLA Ankylosing spondylitis may be caused by an inappropriate immune response to?
✔ Correct Answer--klebsiella pneumonia
what are the 4 primary triggers for autoimmune disease? ✔ Correct Answer--
trauma, infection, toxin and foods
what nutrients are NFkB inhibitors? ✔ Correct Answer--Vitamin C, B12, ALA
over 1/2 of diabetics will have dysfunction of what senses? ✔ Correct Answer--
taste/smell what is the relationship between exogenous estrogen and thyroid function?
✔ Correct Answer--estrogen stimulates production of TSH through feedback to
pituitary
what are estrogens major phase 2 detox pathways? ✔ Correct Answer--
glucuronidation, sulfating, methylation
how prevalent is MTHFR polymorphisms ✔ Correct Answer--40%
ingesting crab prior to toxic metal testing can falsely elevate what metal?
✔ Correct Answer--arsenic
gilberts syndrome is associated with insufficient conjugation of? with?
✔ Correct Answer--bilirubin with glucuronic acid
antibiotic use during childhood has been associated with the development of?
✔ Correct Answer--IBD
Bloating 1-2 Hours postprandial think? ✔ Correct Answer--pancreatic enzyme
deficiency
Is it the left or right part of brain that has special links to emotion, has spacial
and visual imagery? ✔ Correct Answer--Right
which step of GOTOIT prioritizes information ✔ Correct Answer--order
which part of GOTOIT is the subjective and objective material collected?
✔ Correct Answer--organize- like a timeline
what are agents that promote bile production? ✔ Correct
Answer--"cholagogues" like dandelion root, bile salts, taurine, coffee, radishes,
bitters, artichoke, limonene
what are common causes for hypochlorrhydria ✔ Correct Answer--surgery,
autoimmune gastritis, meds, aging, stress, H pylori, iron deficiency, fasting, infection What is the best test to confirm a celiac patient has or has not been compliant
with diet? ✔ Correct Answer--IgG DGP (deaminated gliadin protein)
With Ig___ testing the degree of sensitization does not necessarily = clinical
symptomology ✔ Correct Answer--IgG
What nutrients have been shown to help heal intestinal permeability ✔ Correct
Answer--L-glutamine, N-acetyl-D-glucosamine, Zinc, gamma-linoleic acid
what is lab marker for vulnerability of plaque ✔ Correct Answer--Lp-PLA
What is the ideal waist-to-hip ratio for women in America? ✔ Correct Answer--
What is cut off for women and men for waist circumference in USA ✔ Correct
Answer--Women >35, Men >
Homocysteine lowering treatments are effective for primary or secondary
prevent of CVD? ✔ Correct Answer--primary
which stage of change is someone in when they are intending to take action in
next month? ✔ Correct Answer--preparation
what stage of change is someone in if they are intending to take action in next 6
months? ✔ Correct Answer--conteplation
what stage of change is someone in if they solved problem more than 6 months
ago ✔ Correct Answer--maintenance
what are nutrients for GI repair and healing ✔ Correct Answer--glutamine,
arginine, Vit A, D, C, E, Zn, carotenoids, pantothenic acid
how do you support the mucosal lining of gut? ✔ Correct Answer--PC
How do you support GALT function ✔ Correct Answer--lactoferrin,
lactoperoxidase, whey immunoglobulins
What does bloating directly (15-20 min) after meals indicate ✔ Correct Answer--
low stomach acid
what does delayed onset bloating. ✔ Correct Answer--
what are signs/sx of hypochlorhydria ✔ Correct Answer--bloating/belching 15-
20min after meal, food sits in stomach, fullness after eating, gas, dyspepsia, AM diarrhea, constipation, n/v
what are consequences of low stomach acid? ✔ Correct Answer--SIBO,
parasites, chronic candida, H pylori, iron deficiency, B12 and mineral deficiency
what are signs/sx of low bile salts ✔ Correct Answer--steatorrhea, diarrhea,
bitter taste after meals, n/v, fullness feeling
What is lysozyme a marker of? ✔ Correct Answer--colonic inflammatory activity
(levels >2000 may be suggestive of IBD) Which has better sensitivity DGP (deaminated gliadin peptide) IGG or IGA
✔ Correct Answer--IgG
Patients with Celiac are 5x more likely to have Ig__ Deficiency ✔ Correct
Answer--IgA
What stage of adrenal dysfunction is it when DHEA is low and cortisol is high?
✔ Correct Answer--stage 2, early decompensation
what is high risk in terms of omega-3 index (in%) ✔ Correct Answer--<4%
(assoc with 10x risk of sudden cardiac death)
What herbs for stage 1 adrenal dysfunction (arousal) ✔ Correct Answer--
Ashwagandha, holy basil, L-theanine, 5-HTP, passion flower, valerian root, Kava kava, Rehmannia, schisandra, polygala
what herbs/botanicals for stage 2 adrenal dsyfunction (adaptation) ✔ Correct
Answer--Ashwagandha, rhodiola, coryceps, siberian ginseng, Șt. John's wort,
phosphatidylserine, dark chocolate
what herbs/botanicals for stage 3 adrenal dsyfunction (exhaustion) ✔ Correct
Answer--Ashwagandha, licorice, rehmannia, cordyceps, asian ginseng
what is sergent's white line? When do you see it? ✔ Correct Answer--after line
drawn on abdomen a white line (not red) and remains for several minutes. Adrenal dysfunction
what is seen on eye exam with adrenal dysfunction? ✔ Correct Answer--pupils
cannot hold contraction with light shone into eye
what are signs/sx of low cortisol? ✔ Correct Answer--fatigue, anxiety (esp under
stress), apathy, memory loss, allergies, orthostatic hypotension, insomnia (night waking), craving salty/vinegar food, anorexia/nausea, early onset menopause and peri menopause, decreased immunity
what is a normal cortisol/DHEA ratio? ✔ Correct Answer--5:1 to 6:
what nutrient is required to make ATP biologically active? ✔ Correct Answer--
magnesium What moderates the oxidate stress from ATP production in ATP synthase?
✔ Correct Answer--lipoic acid
what nutrients are essential for Complex 1 in electron transport chain
✔ Correct Answer--riboflavin, niacin
what nutrients are essential for Complex 2 in electron transport chain
✔ Correct Answer--riboflavin
what toxins mess up complex 1 in ETC? ✔ Correct Answer--Tylenol, rotenone,
amytal
what toxins mess up complex 3 in ETC? ✔ Correct Answer--antimycin A
what toxins mess up complex 4 in ETC? ✔ Correct Answer--Carbon monoxide,
cyanide, azide
what toxins mess up ATP synthase in ETC? ✔ Correct Answer--oligomysin
What is genetic "hub" for less injury from oxidative molecules and where does it
come from? ✔ Correct Answer--NRF-2 (gives more GSH, SOD, CAT). Cruciferous
veggies (sulforaphane)
what is genetic "hub" for more and better mitochondria ✔ Correct Answer--
PCG-1alpha
what helps turn on PCG-1alpha ✔ Correct Answer--exercise, fasting, cold
temperature, ALA, T3, NO, small amount of mito damage, Sirt1 (deacetylase) what is most sensitive marker for liver toxicity and mitochondrial dysfunction,
oxidative stress and POP accumulation ✔ Correct Answer--GGT
which body organs use the most energy ✔ Correct Answer--brain and muscle
22%, liver 21%
which nutrients support ETC (e- transport chain) ✔ Correct Answer--CoQ10, Mg
which nutrients support Redox metabolism ✔ Correct Answer--NAC, Vit D,
Folate, B12, SAMe
which nutrients are electron carrier support ✔ Correct Answer--riboflavin (B2),
Niacin (B3)
which nutrients are mitochondrial enzyme cofactors ✔ Correct Answer--
thiamine (B1), pantothenic acid (B5), pyridoxine (B6), biotin (B7), ALA
what nutrients support fatty acid oxidation ✔ Correct Answer--L-carnitine or
acetyl L-carnitine, iodine (B&)
what nutrients support citric acid cycle ✔ Correct Answer--arginine, free form
AA
what are indirect anti-oxidants that support detox? ✔ Correct Answer--
sulforaphane, silymarin, EGCG, resveratrol, curcumin
what are direct antioxidants that support detox? ✔ Correct Answer--Vit E, Vit C,
CoQ10, ALA, L-carnitine, K2-MK
What is the preferred way tryptophan is metabolized? ✔ Correct Answer--
tryptophan -> 5-HTP (needs iron) -> serotonin (needs B6) -> melatonin (needs SAMe) When tryptophan is metabolized via indolamine deoxygenate what is the
consequence and biproducts? ✔ Correct Answer--Causes chronic fatigue.
Kynuric acid, Quinolate
what induces tryptophan metabolism via indolamine deoxygenate? ✔ Correct
Answer--NFkb, TNF-a, IL6, IL1, INFgamma
what down regulates indolamine deoxygenate pathway of tryptophan
metabolism? ✔ Correct Answer--Niacin and estradiol
what blocks the uptake of tryptophan in brain? ✔ Correct Answer--branch chain
amino acids
what is mitochondrial function work up? ✔ Correct Answer--CBC, ferritin, CMP,
A1c, insulin ammonia, lactate, lactate: pyruvate, CK, plasma amino acids, Organic acids, plasma acyl-carnitine profile, CoQ10, ox stress markers what are the following signs/Sx suggestive of? ptosis, ophthalmoplegia, renal wasting, cardiomyopathy, diabetes, hypoglycemia, liver failure, fatigue,
depression, migraines, HA, muscle wasting, EPI, neuropathic pain ✔ Correct
Answer--mitochondrial issues
What enzymes does the body use to protect from ROS? ✔ Correct Answer--
catalase (Fe), SOD (Zn, Cu, Mn), glutathione peroxidase (Se), glutathione reductase what direct anti-oxidants does the body use to protect from ROS in: aqueous compartments
Lipid compartments? ✔ Correct Answer--Vit C
Vit E
What supplements or nutrients to give for remyelination ✔ Correct Answer--
choline, PC what do you think about with: pallor, tachycardia, systolic ejection murmur
✔ Correct Answer--anemia
what do you think about with: blue sclera ✔ Correct Answer--iron deficiency
what do you think about with: jaundice, palmar erythema, dupuytren's
contracture ✔ Correct Answer--chronic liver disease
